Horm Metab Res
DOI: 10.1055/a-2276-7973
Yan Yang
1
Department of Endocrinology and Metabolism, Lanzhou University Second
Hospital, Lanzhou, China
,
Jiyuan Xiao
2
Department of Pharmacology, Lanzhou University Second Hospital,
Lanzhou, China
,
Wen Qiu
2
Department of Pharmacology, Lanzhou University Second Hospital,
Lanzhou, China
,
Luxia Jiang
3
Department of Cardiac Surgery ICU, Lanzhou University Second Hospital,
Lanzhou, China
› Author Affiliations
Funding Information
Health Industry Scientific Research Project of Gansu Province — GSWSKY2018–35
“Cuiying Science and Technology Innovation” program of Lanzhou University Second
Hospital — CY2018-MS01
National Natural Science Foundation of China —
http://dx.doi.org/10.13039/501100001809; 81960165
› Further Information
Also available at
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Abstract
The medical community acknowledges the presence of thyroid disorders and
nonalcoholic fatty liver disease (NAFLD). Nevertheless, the interconnection
between these two circumstances is complex. Thyroid hormones (THs), including
triiodothyronine (T3) and thyroxine (T4), and thyroid-stimulating hormone (TSH),
are essential for maintaining metabolic balance and controlling the metabolism
of lipids and carbohydrates. The therapeutic potential of THs, especially those
that target the TRβ receptor isoform, is generating increasing interest. The
review explores the pathophysiology of these disorders, specifically examining
the impact of THs on the metabolism of lipids in the liver. The purpose of this
review is to offer a thorough analysis of the correlation between thyroid
disorders and NAFLD, as well as suggest potential therapeutic approaches for the
future.
Keywords
thyroid disorders -
NAFLD -
pathophysiology -
therapeutics
Publication History
Received: 16 December 2023
Accepted after revision: 26 February 2024
Accepted Manuscript online:
26 February 2024
Article published online:
05 April 2024
© 2024. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart,
Germany
References
1
Wainwright P,
Byrne CD.
Bidirectional relationships and disconnects between NAFLD and features of the
metabolic syndrome. Int J Mol Sci 2016; 17: 367
2
Younossi Z,
Anstee QM,
Marietti M.
et al.
Global burden of NAFLD and NASH: trends, predictions, risk factors and
prevention. Nat Rev Gastroenterol Hepatol 2018; 15: 11-20
3
Fröhlich E,
Wahl R.
Insight into potential interactions of thyroid hormones, sex ormones and their
stimulating hormones in the development of non-alcoholic fatty liver
disease. Metabolites 2022; 12: 718
4
Tarantino G,
Sinatti G,
Citro V.
et al.
Sarcopenia, a condition shared by various diseases: can we alleviate or delay
the progression?. Intern Emerg Med 2023; 18: 1887-1895
5
Mandato C,
D'Acunzo I,
Vajro P.
Thyroid dysfunction and its role as a risk factor for non-alcoholic fatty liver
disease: what's new. Dig Liver Dis 2018; 50: 1163-1165
6
Chen J,
Wei L,
Zhu X.
et al.
TT3, a more practical indicator for evaluating the relationship between
sarcopenia and thyroid hormone in the euthyroid elderly compared with FT3. Clin Interv Aging 2023; 18: 1285-1293
7
Chaker L,
Bianco AC,
Jonklaas J.
et al.
Hypothyroidism. Lancet 2017; 390: 1550-1562
8
Bano A,
Chaker L,
Plompen EP.
et al.
Thyroid function and the risk of nonalcoholic fatty liver disease: the Rotterdam
study. J Clin Endocrinol Metab 2016; 101: 3204-3211
9
Xu C,
Xu L,
Yu C.
et al.
Association between thyroid function and nonalcoholic fatty liver disease in
euthyroid elderly Chinese. Clin Endocrinol (Oxf) 2011; 75: 240-246
10
Ludwig U,
Holzner D,
Denzer C.
et al.
Subclinical and clinical hypothyroidism and non-alcoholic fatty liver disease: a
cross-sectional study of a random population sample aged 18 to 65 years. BMC Endocr Disord 2015; 15: 41
11
Manka P,
Bechmann L,
Best J.
et al.
Low free triiodothyronine is associated with advanced fibrosis in patients at
high risk for nonalcoholic steatohepatitis. Dig Dis Sci 2019; 64: 2351-2358
12
Mantovani A,
Nascimbeni F,
Lonardo A.
et al.
Association between primary hypothyroidism and nonalcoholic fatty liver disease:
a systematic review and meta-analysis. Thyroid 2018; 28: 1270-1284
13
Chung GE,
Kim D,
Kim W.
et al.
Non-alcoholic fatty liver disease across the spectrum of hypothyroidism. J Hepatol 2012; 57: 150-156
14
Martínez-Escudé A,
Pera G,
Costa-Garrido A.
et al.
TSH levels as an independent risk factor for NAFLD and liver fibrosis in the
general population. J Clin Med 2021; 10: 2907
15
Bril F,
Kadiyala S,
Portillo Sanchez P.
et al.
Plasma thyroid hormone concentration is associated with hepatic triglyceride
content in patients with type 2 diabetes. J Investig Med 2016; 64: 63-68
16
Lee KW,
Bang KB,
Rhee EJ.
et al.
Impact of hypothyroidism on the development of non-alcoholic fatty liver
disease: a 4-year retrospective cohort study. Clin Mol Hepatol 2015; 21: 372-378
17
Jaruvongvanich V,
Sanguankeo A,
Upala S.
Nonalcoholic fatty liver disease is not associated with thyroid hormone levels
and hypothyroidism: a systematic review and meta-analysis. Eur Thyroid J 2017; 6: 208-215
18
He W,
An X,
Li L.
et al.
Relationship between hypothyroidism and non-alcoholic fatty liver disease: a
systematic review and meta-analysis. Front Endocrinol (Lausanne) 2017; 8: 335
19
Guo Z,
Li M,
Han B.
et al.
Association of non-alcoholic fatty liver disease with thyroid function: a
systematic review and meta-analysis. Dig Liver Dis 2018; 50: 1153-1162
20
Mullur R,
Liu YY,
Brent GA.
Thyroid hormone regulation of metabolism. Physiol Rev 2014; 94: 355-382
21
Ritter MJ,
Amano I,
Hollenberg AN.
Thyroid hormone signaling and the liver. Hepatology 2020; 72: 742-752
22
Liao CJ,
Huang PS,
Chien HT.
et al.
Effects of thyroid hormones on lipid metabolism pathologies in non-alcoholic
fatty liver disease. Biomedicines 2022; 10: 1232
23
Hammes SR,
Davis PJ.
Overlapping nongenomic and genomic actions of thyroid hormone and steroids. Best Pract Res Clin Endocrinol Metab 2015; 29: 581-593
24
Senese R,
Cioffi F,
de Lange P.
et al.
Both 3,5-diiodo-L-thyronine and 3,5,3'-triiodo-L-thyronine prevent
short-term hepatic lipid accumulation via distinct mechanisms in rats being fed
a high-fat diet. Front Physiol 2017; 8: 706
25
Liu YY,
Brent GA.
Thyroid hormone crosstalk with nuclear receptor signaling in metabolic
regulation. Trends Endocrinol Metab 2010; 21: 166-173
26
Berlanga A,
Guiu-Jurado E,
Porras JA.
et al.
Molecular pathways in non-alcoholic fatty liver disease. Clin Exp Gastroenterol 2014; 7: 221-239
27
Hashimoto K,
Ishida E,
Miura A.
et al.
Human stearoyl-CoA desaturase 1 (SCD-1) gene expression is negatively regulated
by thyroid hormone without direct binding of thyroid hormone receptor to the
gene promoter. Endocrinology 2013; 154: 537-549
28
Sinha RA,
Bruinstroop E,
Singh BK.
et al.
Nonalcoholic fatty liver disease and hypercholesterolemia: roles of thyroid
hormones, metabolites, and agonists. Thyroid 2019; 29: 1173-1191
29
Santana-Farré R,
Mirecki-Garrido M,
Bocos C.
et al.
Influence of neonatal hypothyroidism on hepatic gene expression and lipid
metabolism in adulthood. PLoS One 2012; 7: e37386
30
Klieverik LP,
Coomans CP,
Endert E.
et al.
Thyroid hormone effects on whole-body energy homeostasis and tissue-specific
fatty acid uptake in vivo. Endocrinology 2009; 150: 5639-5648
31
Mukhopadhyay D,
Plateroti M,
Anant S.
et al.
Thyroid hormone regulates hepatic triglyceride mobilization and apolipoprotein B
messenger ribonucleic Acid editing in a murine model of congenital
hypothyroidism. Endocrinology 2003; 144: 711-719
32
Sinha RA,
Singh BK,
Yen PM.
Direct effects of thyroid hormones on hepatic lipid metabolism. Nat Rev Endocrinol 2018; 14: 259-269
33
Perra A,
Simbula G,
Simbula M.
et al.
Thyroid hormone (T3) and TRbeta agonist GC-1 inhibit/reverse nonalcoholic fatty
liver in rats. FASEB J 2008; 22: 2981-2989
34
Sinha RA,
You SH,
Zhou J.
et al.
Thyroid hormone stimulates hepatic lipid catabolism via activation of
autophagy. J Clin Invest 2012; 122: 2428-2438
35
Sinha RA,
Singh BK,
Zhou J.
et al.
Thyroid hormone induction of mitochondrial activity is coupled to mitophagy via
ROS-AMPK-ULK1 signaling. Autophagy 2015; 11: 1341-1357
36
Singh BK,
Sinha RA,
Tripathi M.
et al.
Thyroid hormone receptor and ERRα coordinately regulate mitochondrial fission,
mitophagy, biogenesis, and function. Sci Signal 2018; 11: eaam5855
37
Weitzel JM,
Iwen KA.
Coordination of mitochondrial biogenesis by thyroid hormone. Mol Cell Endocrinol 2011; 342: 1-7
38
Bruinstroop E,
Zhou J,
Tripathi M.
et al.
Early induction of hepatic deiodinase type 1 inhibits hepatosteatosis during
NAFLD progression. Mol Metab 2021; 53: 101266
39
Bohinc BN,
Michelotti G,
Xie G.
et al.
Repair-related activation of hedgehog signaling in stromal cells promotes
intrahepatic hypothyroidism. Endocrinology 2014; 155: 4591-4601
40
Fazaeli M,
Khoshdel A,
Shafiepour M.
et al.
The influence of subclinical hypothyroidism on serum lipid profile, PCSK9 levels
and CD36 expression on monocytes. Diabetes Metab Syndr 2019; 13: 312-316
41
Bonde Y,
Breuer O,
Lütjohann D.
et al.
Thyroid hormone reduces PCSK9 and stimulates bile acid synthesis in humans. J Lipid Res 2014; 55: 2408-2415
42
Ness GC,
Pendleton LC,
Li YC.
et al.
Effect of thyroid hormone on hepatic cholesterol 7 alpha hydroxylase, LDL
receptor, HMG-CoA reductase, farnesyl pyrophosphate synthetase and
apolipoprotein A-I mRNA levels in hypophysectomized rats. Biochem Biophys Res Commun 1990; 172: 1150-1156
43
Bonde Y,
Plösch T,
Kuipers F.
et al.
Stimulation of murine biliary cholesterol secretion by thyroid hormone is
dependent on a functional ABCG5/G8 complex. Hepatology 2012; 56: 1828-1837
44
Lugari S,
Mantovani A,
Nascimbeni F.
et al.
Hypothyroidism and nonalcoholic fatty liver disease – a chance association?. Horm Mol Biol Clin Investig 2018; 41 DOI:
10.1515/hmbci-2018-0047.
45
Tian L,
Song Y,
Xing M.
et al.
A novel role for thyroid-stimulating hormone: up-regulation of hepatic
3-hydroxy-3-methyl-glutaryl-coenzyme A reductase expression through the cyclic
adenosine monophosphate/protein kinase A/cyclic adenosine
monophosphate-responsive element binding protein pathway. Hepatology 2010; 52: 1401-1409
46
Song Y,
Xu C,
Shao S.
et al.
Thyroid-stimulating hormone regulates hepatic bile acid homeostasis via
SREBP-2/HNF-4α/CYP7A1 axis. J Hepatol 2015; 62: 1171-1179
47
Gong Y,
Ma Y,
Ye Z.
et al.
Thyroid stimulating hormone exhibits the impact on LDLR/LDL-c via up-regulating
hepatic PCSK9 expression. Metabolism 2017; 76: 32-41
48
Beukhof CM,
Massolt ET,
Visser TJ.
et al.
Effects of thyrotropin on peripheral thyroid hormone metabolism and serum
lipids. Thyroid 2018; 28: 168-174
49
Huang YY,
Gusdon AM,
Qu S.
Cross-talk between the thyroid and liver: a new target for nonalcoholic fatty
liver disease treatment. World J Gastroenterol 2013; 19: 8238-8246
50
Torun AN,
Kulaksizoglu S,
Kulaksizoglu M.
et al.
Serum total antioxidant status and lipid peroxidation marker malondialdehyde
levels in overt and subclinical hypothyroidism. Clin Endocrinol (Oxf) 2009; 70: 469-474
51
Jou J,
Choi SS,
Diehl AM.
Mechanisms of disease progression in nonalcoholic fatty liver disease. Semin Liver Dis 2008; 28: 370-379
52
Kokkinos A,
Mourouzis I,
Kyriaki D.
et al.
Possible implications of leptin, adiponectin and ghrelin in the regulation of
energy homeostasis by thyroid hormone. Endocrine 2007; 32: 30-32
53
Messarah M,
Boumendjel A,
Chouabia A.
et al.
Influence of thyroid dysfunction on liver lipid peroxidation and antioxidant
status in experimental rats. Exp Toxicol Pathol 2010; 62: 301-310
54
Kumar A,
Sinha RA,
Tiwari M.
et al.
Hyperthyroidism induces apoptosis in rat liver through activation of death
receptor-mediated pathways. J Hepatol 2007; 46: 888-898
55
Krause C,
Grohs M,
El Gammal AT.
et al.
Reduced expression of thyroid hormone receptor β in human nonalcoholic
steatohepatitis. Endocr Connect 2018; 7: 1448-1456
56
Liu L,
Yu Y,
Zhao M.
et al.
Benefits of levothyroxine replacement therapy on nonalcoholic fatty liver
disease in subclinical hypothyroidism patients. Int J Endocrinol 2017; 5753039 DOI:
10.1155/2017/5753039.
57
Saponaro F,
Sestito S,
Runfola M.
et al.
Selective thyroid hormone receptor-beta (TRβ) agonists: new perspectives for the
treatment of metabolic and neurodegenerative disorders. Front Med (Lausanne) 2020; 7: 331
58
Araki O,
Ying H,
Zhu XG.
et al.
Distinct dysregulation of lipid metabolism by unliganded thyroid hormone
receptor isoforms. Mol Endocrinol 2009; 23: 308-315
59
Jornayvaz FR,
Lee HY,
Jurczak MJ.
et al.
Thyroid hormone receptor-α gene knockout mice are protected from diet-induced
hepatic insulin resistance. Endocrinology 2012; 153: 583-591
60
Vatner DF,
Weismann D,
Beddow SA.
et al.
Thyroid hormone receptor-β agonists prevent hepatic steatosis in fat-fed rats
but impair insulin sensitivity via discrete pathways. Am J Physiol Endocrinol Metab 2013; 305: E89-E100
61
Puliga E,
Min Q,
Tao J.
et al.
Thyroid hormone receptor-β agonist GC-1 inhibits met-β-catenin-driven
hepatocellular cancer. Am J Pathol 2017; 187: 2473-2485
62
Finan B,
Clemmensen C,
Zhu Z.
et al.
Chemical hybridization of glucagon and thyroid hormone optimizes therapeutic
impact for metabolic disease. Cell 2016; 167: 843-857.e14
63
Erion MD,
Cable EE,
Ito BR.
et al.
Targeting thyroid hormone receptor-beta agonists to the liver reduces
cholesterol and triglycerides and improves the therapeutic index. Proc Natl Acad Sci U S A 2007; 104: 15490-15495
64
Cable EE,
Finn PD,
Stebbins JW.
et al.
Reduction of hepatic steatosis in rats and mice after treatment with a
liver-targeted thyroid hormone receptor agonist. Hepatology 2009; 49: 407-417
65
Zhou J,
Waskowicz LR,
Lim A.
et al.
A liver-specific thyromimetic, VK2809, decreases hepatosteatosis in glycogen
storage disease type Ia. Thyroid 2019; 29: 1158-1167
66
Loomba R,
Neutel J,
Mohseni R.
et al.
LBP-20-VK2809, a novel liver-directed thyroid receptor beta agonist,
significantly reduces liver fat with both low and high doses in patients with
non-alcoholic fatty liver disease: a phase 2 randomized, placebo-controlled
trial. J Hepatol 2019; 70: e150-e151
67
Kannt A,
Wohlfart P,
Madsen AN,
Veidal SS.
et al.
Activation of thyroid hormone receptor-β improved disease activity and
metabolism independent of body weight in a mouse model of non-alcoholic
steatohepatitis and fibrosis. Br J Pharmacol 2021; 178: 2412-2423
68
Mollica MP,
Lionetti L,
Moreno M.
et al.
3,5-Diiodo-l-thyronine, by modulating mitochondrial functions, reverses hepatic
fat accumulation in rats fed a high-fat diet. J Hepatol 2009; 51: 363-370
69
de Lange P,
Cioffi F,
Senese R.
et al.
Nonthyrotoxic prevention of diet-induced insulin resistance by
3,5-diiodo-L-thyronine in rats. Diabetes 2011; 60: 2730-2739
70
Grasselli E,
Voci A,
Demori I.
et al.
3,5-Diiodo-L-thyronine modulates the expression of genes of lipid metabolism in
a rat model of fatty liver. J Endocrinol 2012; 212: 149-158
71
Perra A,
Kowalik MA,
Cabras L.
et al.
Potential role of two novel agonists of thyroid hormone receptor-β on liver
regeneration. Cell Prolif 2020; 53: e12808
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